Esmeralda Mentado
Oceanside,CA
Summary
Resourceful Team Member with proven history of reliability and excellent work. Dedicated to quality assurance and maximizing daily progress.
Overview
12
12
years of professional experience
Work History
Front Desk Coordinator
UCSD Health
02.2023 - Current
- Scheduled appointments in Epic.
- Verified insurance utilizing DAR monthly.
- Worked through the in-basket for patient scheduling and questions within a 72-hour turnaround time.
- Completed follow-up and consults referrals through the work queue for Nephrology.
- Transcribe consult orders to Nephrology for RN review before scheduling.
- Informed patient of denials from insurance regarding consult or follow-up appointments.
Scheduling Specialist
Scripps Health
01.2022 - 02.2023
- Scheduling and confirming appointments in person or over the phone and entering appropriate insurance
- Completed check-in process with patients
- Called Cardiac CT patients to coordinate schedules and set appointments.
- Scheduled CT orders for outside Kaiser patients, Scripps Cardiologist, and outside cardiologist
- Assisted internal staff with clerical and administrative needs to maximize efficiency and team productivity.
Lead Referral Coordinator
The Neurology Center
09.2019 - 01.2022
- Obtain authorizations and referrals for patients
- Review pending authorizations and follow up every three days to ensure timely patient care
- Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout the process.
- Called insurance companies to get precertification and other benefits information on behalf of patients.
- Assisted patients with questions regarding their referrals i.e., redirects, site information, or problems
- Received new referrals from outside providers and inputted them into Epic with the correct insurance and demographics
- Helped with any upset patients in de-escalating the situation and finding a solution
- Completed up to 75-100 referral requests each day for medical providers of Neurology services.
Medical Billing Specialist
Breg Inc
06.2019 - 08.2019
- Coordinated and facilitated new orders from the field representatives
- Performed verification of benefits; contacted patients to inform them of their benefits and collect co-Insurance
- Performed patient registration and check-out procedures
- Served as point of contact for sales and service representatives on such things as updates to orders, patient communication, and account issues to address
- Performed order entry into Breg Claim System (BCS) for billing of products and services
- Coordinated delivery of ancillary products
- Submitted prior and retro authorizations
- Posted and adjusted payments from insurance companies.
- Examined patients' insurance coverage, deductibles, insurance carrier payments, and remaining balances not covered under policies when applicable.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
Registration Clerk
North County Health Services
05.2015 - 06.2019
- Prepare patients for a medical visit by independently coordinating the registration process to ensure efficient and effective operations of the clinic
- Verify insurance and reviews patient’s coverage for OB/GYN services
- Verified insurance benefits and obtained pre-authorizations before any medical procedures were performed.
- Run insurance eligibility for patient's payer on file
- Followed up with referrals that were expired by contacting the specialist office or patient to close out a referral.
Account Team Member
NCRC Inc.
10.2013 - 05.2015
- Accept and dispatch Work Orders through Service Channel for NCRC
- Run daily database Excel reports
- Update account managers and account holders on dispatched vendor and technician work orders
- Write up maintenance repair bids for clients with proper P&O and tax
- Gained experience with Excel, Pivotal, IVR, and Interactive Client phone systems.
- Trained new team members by relaying information on company procedures and safety requirements.
Education
Mira Costa College General
Oceanside, CABusiness Office Administration - undefined
UEI College
San Marcos, CAundefined
San Dieguito Academy
Encinitas, CASkills
- Bilingual
- EMR System Experience
- Scheduling
- Microsoft Excel, Word, and PowerPoint
- Health Insurance
- Customer Service
- Spanish Interpreting
- Insurance Eligibility
- Customer Complaint Resolution
Languages
Spanish
Professional Working
Timeline
Front Desk Coordinator
UCSD Health
02.2023 - Current
Scheduling Specialist
Scripps Health
01.2022 - 02.2023
Lead Referral Coordinator
The Neurology Center
09.2019 - 01.2022
Medical Billing Specialist
Breg Inc
06.2019 - 08.2019
Registration Clerk
North County Health Services
05.2015 - 06.2019
Account Team Member
NCRC Inc.
10.2013 - 05.2015
Business Office Administration - undefined
UEI College
undefined
San Dieguito Academy
Mira Costa College General
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